更新于：2024-09-06
Aspirin/Dipyridamole
阿司匹林/双嘧达莫
更新于：2024-09-06
概要
基本信息
最高研发阶段批准上市 |
首次获批日期 中国 (1994-01-01), |
最高研发阶段(中国)批准上市 |
特殊审评- |
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结构
分子式C33H48N8O8 |
InChIKeyNOHUXXDTQJPXSB-UHFFFAOYSA-N |
CAS号87653-67-6 |
关联
28
项与 阿司匹林/双嘧达莫 相关的临床试验A Randomized Controlled Trial to Evaluate the Outcomes With Aggrenox in Patients With SARS-CoV-2 Infection
PercutaNEOus Coronary Intervention Followed by Monotherapy INstead of Dual Antiplatelet Therapy in the SETting of Acute Coronary Syndromes: The NEO-MINDSET Trial A Drug Reduction Study for Patients With Acute Coronary Syndrome in the Unified Health System in Brazil
Dipyridamole Assessment for Flare Reduction in SLE
100 项与 阿司匹林/双嘧达莫 相关的临床结果
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100 项与 阿司匹林/双嘧达莫 相关的转化医学
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100 项与 阿司匹林/双嘧达莫 相关的专利（医药）
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56
项与 阿司匹林/双嘧达莫 相关的文献（医药）2019-01-11Pain physician3区 · 医学
Responsible, Safe, and Effective Use of
Antithrombotics and Anticoagulants in
Patients Undergoing Interventional Techniques:
American Society of Interventional Pain
Physicians (ASIPP) Guidelines
3区 · 医学
Review
作者: Amol Soin ; Cyrus Bakhit ; Ramarao Pasupuleti ; Sudhir Diwan ; Jay S. Grider ; Michael E. Harned ; Muhammad Anwar ; Ramsin M. Benyamin ; Kenneth D. Candido ; Matthew R. Eng ; Mahendra Sanapati ; Elyse M. Cornett ; Matthew B. Novitch ; Hari Prabhakar ; Nebojsa Nick Knezevic ; Mark R. Jones ; Imran N. Mungrue ; Richard E. Latchaw ; Erik M. Helander ; Joshua A. Hirsch ; Timothy R. Deer ; Alan D. Kaye ; Sheri L. Albers ; John R. Swicegood ; Douglas Beall ; Ricardo Vallejo ; Thomas T. Simopoulos ; Salahadin Abdi ; Laxmaiah Manchikanti ; Richard D. Urman ; Sairam Atluri
Background: Interventional pain management involves diagnosis and treatment of chronic
pain. This specialty utilizes minimally invasive procedures to target therapeutics to the central
nervous system and the spinal column. A subset of patients encountered in interventional pain are
medicated using anticoagulant or antithrombotic drugs to mitigate thrombosis risk. Since these
drugs target the clotting system, bleeding risk is a consideration accompanying interventional
procedures. Importantly, discontinuation of anticoagulant or antithrombotic drugs exposes
underlying thrombosis risk, which can lead to significant morbidity and mortality especially in those
with coronary artery or cerebrovascular disease. This review summarizes the literature and provides
guidelines based on best evidence for patients receiving anti-clotting therapy during interventional
pain procedures.
Study Design: Best evidence synthesis.
Objective: To provide a current and concise appraisal of the literature regarding an assessment
of the bleeding risk during interventional techniques for patients taking anticoagulant and/or
antithrombotic medications.
Methods: A review of the available literature published on bleeding risk during interventional pain
procedures, practice patterns and perioperative management of anticoagulant and antithrombotic
therapy was conducted. Data sources included relevant literature identified through searches of
EMBASE and PubMed from 1966 through August 2018 and manual searches of the bibliographies
of known primary and review articles.
Results:
1. There is good evidence for risk stratification by categorizing multiple interventional
techniques into low-risk, moderate-risk, and high-risk. Also, their risk should be upgraded based on other risk factors.
2. There is good evidence for the risk of thromboembolic events in patients who interrupt antithrombotic therapy.
3. There is good evidence supporting discontinuation of low dose aspirin for high risk
and moderate risk procedures for at least 3 days, and there is moderate evidence that
these may be continued for low risk or some intermediate risk procedures.4. There is good evidence that discontinuation of anticoagulant therapy with warfarin, heparin, dabigatran
(Pradaxa®), argatroban (Acova®), bivalirudin (Angiomax®), lepirudin (Refludan®), desirudin (Iprivask®), hirudin,
apixaban (Eliquis®), rivaroxaban (Xarelto®), edoxaban (Savaysa®, Lixiana®), Betrixaban(Bevyxxa®), fondaparinux
(Arixtra®) prior to interventional techniques with individual consideration of pharmacokinetics and pharmacodynamics of the drugs and individual risk factors increases safety.
5. There is good evidence that diagnosis of epidural hematoma is based on severe pain at the site of the injection,
rapid neurological deterioration, and MRI with surgical decompression with progressive neurological dysfunction
to avoid neurological sequelae.
6. There is good evidence that if thromboembolic risk is high, low molecular weight heparin bridge therapy can be
instituted during cessation of the anticoagulant, and the low molecular weight heparin can be discontinued 24
hours before the pain procedure.
7. There is fair evidence that the risk of thromboembolic events is higher than that of epidural hematoma formation with the interruption of antiplatelet therapy preceding interventional techniques, though both risks are
significant.
8. There is fair evidence that multiple variables including anatomic pathology with spinal stenosis and ankylosing
spondylitis; high risk procedures and moderate risk procedures combined with anatomic risk factors; bleeding
observed during the procedure, and multiple attempts during the procedures increase the risk for bleeding complications and epidural hematoma.
9. There is fair evidence that discontinuation of phosphodiesterase inhibitors is optional (dipyridamole [Persantine],
cilostazol [Pletal]. However, there is also fair evidence to discontinue Aggrenox [dipyridamole plus aspirin]) 3 days
prior to undergoing interventional techniques of moderate and high risk.
10. There is fair evidence to make shared decision making between the patient and the treating physicians with the
treating physician and to consider all the appropriate risks associated with continuation or discontinuation of
antithrombotic or anticoagulant therapy.
11. There is fair evidence that if thromboembolic risk is high antithrombotic therapy may be resumed 12 hours after
the interventional procedure is performed.
12. There is limited evidence that discontinuation of antiplatelet therapy (clopidogrel [Plavix®], ticlopidine [Ticlid®], Ticagrelor [Brilinta®] and prasugrel [Effient®]) avoids complications of significant bleeding and epidural
hematomas.
13. There is very limited evidence supporting the continuation or discontinuation of most NSAIDs, excluding aspirin,
for 1 to 2 days and some 4 to 10 days, since these are utilized for pain management without cardiac or cerebral
protective effect.
Limitations: The continued paucity of the literature with discordant recommendations.
Conclusion: Based on the survey of current literature, and published clinical guidelines, recommendations for patients presenting
with ongoing antithrombotic therapy prior to interventional techniques are variable, and are based on comprehensive analysis of
each patient and the risk-benefit analysis of intervention.
Key words: Perioperative bleeding, bleeding risk, practice patterns, anticoagulant therapy, antithrombotic therapy, interventional
techniques, safety precautions, pain
2019-01-01Journal of thrombosis and haemostasis : JTH2区 · 医学
Preventing arteriovenous shunt failure in hemodialysis patients: a population‐based cohort study
2区 · 医学
Article
作者: Wu, H H ; Yang, C W ; Chang, T-Y ; Liu, S H ; Lee, C C ; Kuo, C F ; Tian, Y C ; Weng, C H ; Hsieh, M Y ; Fan, P Y ; Tu, K H ; Li, I-J
Essentials Uncertainty remains about antiplatelets for vascular access patency in hemodialysis patients. 95 971 people under hemodialysis were followed in a claims database in Taiwan. Aspirin reduced vascular access failure rate and did not increase major bleeding rate. Clopidogrel, Aggrenox, and warfarin might increase major bleeding rate. SUMMARY: Background Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. Objectives This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Patients and methods We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from 1 January 1997 to 31 December 2012. A total of 95 971 patients were enrolled in our study. Vascular access dysfunction was defined as the need for thrombectomy or percutaneous angioplasty. Major bleeding was defined as emergency department visits or hospitalization with a primary diagnosis of gastrointestinal bleeding or intracerebral hemorrhage. The adjusted odds ratios between person-quarters with or without antiplatelet or oral anticoagulant use were calculated using a generalized estimating equation. Results The odds ratio of vascular access failure was 0.21 (0.11-0.39) for aspirin, 0.76 (0.74-0.79) for clopidogrel, 0.67 (0.59-0.77) for dipyridamole, 0.67 (0.53-0.86) for Aggrenox and 0.96 (0.90-1.03) for warfarin. The highest odds ratio for intracerebral hemorrhage was 5.33 (1.25-22.72) in younger patients using Aggrenox. The highest odds ratio for gastrointestinal bleeding was 1.34 (1.10-1.64) for clopidogrel. Conclusion Antiplatelet agents, but not warfarin, might reduce the vascular access thrombosis rate. The gastrointestinal bleeding rate was increased in the group using clopidogrel. Aggrenox should be used with caution in young individuals because it might increase the rate of intracerebral hemorrhage.
2018-01-01ANZ journal of surgery4区 · 医学
Trends in the surgical treatment of benign prostatic hyperplasia in a tertiary hospital
4区 · 医学
Article
作者: Papa, Nathan ; Bolton, Damien M. ; Lawrentschuk, Nathan ; Ow, Darren ; Clarke, Stephen ; Sengupta, Shomik ; Liodakis, Peter ; Perera, Marlon
Background:
To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution.
Methods:
We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed.
Results:
In total, 560 cases were included: 204 (36.4%) underwent TURP and 356 (63.6%) PVP. Patients undergoing PVP had higher ASA scores (P < 0.001) and were more frequently on continuing anticoagulant therapy (P < 0.001). With regards to non‐aspirin/asasantin coagulation therapy, 61 (17.1%) patients underwent PVP with their anticoagulants continued while no patients who received TURP continued anticoagulation. Blood transfusion percentages were similar at 1.0% for TURP and 1.7% for PVP but readmission proportions were higher after PVP (32 patients, 9.0%) compared to TURP (10 patients, 4.9%). These differences were attenuated when excluding patients continuing anticoagulation during the procedure.
Conclusion:
At our institution, the use of PVP has been increasing on a year‐by‐year basis. The results of the current study demonstrated that PVP is safe in patients with increased anaesthetic risk or on active anticoagulation when compared to traditional TURP. While this makes PVP an attractive alternative to TURP in high‐risk anticoagulated patients, these patients may have complex post‐discharge issues that should be addressed during the informed consent process.
3
项与 阿司匹林/双嘧达莫 相关的新闻（医药）
2022-04-26
100 项与 阿司匹林/双嘧达莫 相关的药物交易
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研发状态
批准上市
10 条最早获批的记录, 后查看更多信息
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| 适应症 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|
| 脑卒中 | 加拿大 | 2000-04-17 | |
| 短暂性脑缺血发作 | 美国 | 1999-11-22 | |
| 缺血性卒中 | 美国 | 1999-11-22 | |
| 大脑梗塞 | 中国 | 1994-01-01 |
未上市
10 条进展最快的记录, 后查看更多信息
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| 适应症 | 最高研发状态 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|---|
| 新冠肺炎后遗症 | 临床3期 | 美国 | 2020-10-21 | |
| 脑梗塞 | 临床3期 | 日本 | 2006-04-01 | |
| 头痛 | 临床3期 | 中国台湾 | 2002-09-01 |
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临床结果
临床结果
适应症
分期
评价
查看全部结果
N/A | 18 | (Extended Release Dipyridamole/Aspirin) | 膚壓壓鏇夢願窪廠鬱繭(製繭廠築壓簾範遞積襯) = 夢壓蓋衊範齋簾網築鬱 觸網醖膚窪廠遞網壓網 (廠糧鏇製遞廠鹽遞鏇淵, 網製衊餘艱糧遞餘鑰夢 ~ 餘糧積顧鹹夢範艱淵構) 更多 | - | 2020-11-25 | ||
(Aspirin) | 膚壓壓鏇夢願窪廠鬱繭(製繭廠築壓簾範遞積襯) = 遞窪築遞願簾淵齋積鑰 觸網醖膚窪廠遞網壓網 (廠糧鏇製遞廠鹽遞鏇淵, 構鬱夢構積廠齋蓋齋醖 ~ 製衊廠範選襯鹽積獵窪) 更多 | ||||||
N/A | 664 | (Device Closure) | 鹹觸糧襯鏇鹽齋糧壓遞(廠餘遞獵鏇願糧壓願廠) = 襯築壓遞鹹廠壓範糧構 簾網獵餘餘醖築窪簾膚 (襯廠繭範遞構糧衊鬱獵, 壓壓積衊網網憲簾鏇夢 ~ 襯遞鏇觸觸鹽鹹蓋獵範) 更多 | - | 2018-08-09 | ||
(Medical Management) | 鹹觸糧襯鏇鹽齋糧壓遞(廠餘遞獵鏇願糧壓願廠) = 膚鹹蓋顧簾獵築願繭鬱 簾網獵餘餘醖築窪簾膚 (襯廠繭範遞構糧衊鬱獵, 蓋鏇齋鹽築鹽鏇遞齋製 ~ 獵範獵憲獵壓鑰築鹹範) 更多 | ||||||
N/A | 25 | (Dipyridamole 200mg and Aspirin 25mg Bid) | 構鏇築觸鹽觸蓋蓋願糧(夢鑰積構鑰蓋淵鑰窪鏇) = 蓋夢簾鬱鏇願遞膚鏇築 衊構鹹憲糧簾憲夢願襯 (獵憲壓製夢製遞夢齋觸, 鬱選觸鹽衊獵簾夢夢製 ~ 獵夢鑰觸簾鏇範鏇醖顧) 更多 | - | 2017-09-05 | ||
(Dipyridamole 200 mg Bid) | 構鏇築觸鹽觸蓋蓋願糧(夢鑰積構鑰蓋淵鑰窪鏇) = 鏇範憲鹽齋廠鬱艱夢夢 衊構鹹憲糧簾憲夢願襯 (獵憲壓製夢製遞夢齋觸, 鹽廠壓壓廠鑰網簾觸網 ~ 簾網膚製網齋鹹艱餘艱) 更多 | ||||||
临床3期 | 1,295 | (Aggrenox Capsule) | 網製壓廠構製艱襯憲鏇(獵選蓋艱艱觸夢壓襯餘) = 鑰壓鏇蓋窪顧齋鏇鏇艱 築觸淵壓壓鹹簾夢壓餘 (夢選鹹膚積憲衊窪願鏇, 艱廠築鏇觸衊觸廠廠襯 ~ 夢遞鹹夢糧憲積製鑰壓) 更多 | - | 2010-03-11 | ||
Acetylsalicylic Acid (ASA) (Acetylsalicylic Acid (ASA) 81 mg Tablet) | 網製壓廠構製艱襯憲鏇(獵選蓋艱艱觸夢壓襯餘) = 夢簾膚鏇繭製願壓構艱 築觸淵壓壓鹹簾夢壓餘 (夢選鹹膚積憲衊窪願鏇, 窪壓淵網鑰淵簾夢範鏇 ~ 餘積選觸鑰艱網簾選襯) 更多 | ||||||
临床4期 | 20,332 | Dipyridamole+Aspirin (Aspirin + Extended Release Dipyridamole) | 鹹獵鹹範顧觸膚鹹衊鬱(淵壓廠顧築顧襯獵遞糧) = 積獵艱簾顧壓繭窪鹽衊 廠膚鏇獵簾醖鹹蓋鹽醖 (鏇淵製齋網餘廠憲積範, 製廠壓遞壓壓襯淵鏇製 ~ 窪繭築糧鹹廠蓋繭選繭) 更多 | - | 2009-09-02 | ||
Clopidogrel (Clopidogrel) | 鹹獵鹹範顧觸膚鹹衊鬱(淵壓廠顧築顧襯獵遞糧) = 鹽繭醖範淵網鹽淵繭淵 廠膚鏇獵簾醖鹹蓋鹽醖 (鏇淵製齋網餘廠憲積範, 膚築艱製淵繭製窪顧餘 ~ 鹹鹹築願餘選鑰構鬱糧) 更多 |
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